After Exposure of an Impacted Tooth

Immediately Following Surgery

Do not disturb the wound. If surgical packing was placed, leave it alone. The pack helps to keep the tooth exposed. If it gets dislodged or falls out, do not get alarmed.

Unless otherwise instructed, take your first dose of ibuprofen (Motrin or Advil) 400 mg (2 tablets) before the local anesthesia wears off to decrease the initial pain. If you feel it is necessary, you may take the prescribed pain medication.

If it is necessary to take a prescription medication for pain, you may take it in conjunction with the ibuprofen or staggered with the ibuprofen.

Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.

Place ice packs over the surgical site to reduce swelling. Refer to the section on Swelling for an explanation.

Pain

The following dosages are for adults, if the patient is less than 100 lbs, please ask the doctor for appropriate pain medication dosages.

For moderate pain, ibuprofen (Motrin or Advil) 400mg (2 tablets) should be taken every three to four hours on a regular schedule. By taking this pain medication regularly and keeping the blood levels constant, the medication can work better and often less prescription narcotic pain medicine is necessary.

If you cannot take ibuprofen, you can take two, regular strength (325mg) acetaminophen (Tylenol), or one extra strength (500mg) every three to four hours, keeping in mind that no more than 4 grams may be take in 48 hours. The prescription medication may have some of this medication in it as well and should be taken into account.

For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. You may take the prescription medicine it in conjunction with the ibuprofen or staggered with the ibuprofen.

Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

Bleeding

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding which results in your mouth filling rapidly with blood can frequently be controlled by biting with pressure on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues, please call for further instructions.

Swelling

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag or a plastic bag or towel filled with ice cubes on the cheek in the area of surgery. Apply the ice continuously as much as possible for the first 36 hours.

Diet

Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.

Oral Hygiene

Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal beginning the day after surgery. Brush your teeth as best you can. Rinse with warm salt water (one teaspoon of salt in a cup of warm water) six times a day. Continue this procedure until healing is complete.

REMEMBER: A clean wound heals better and faster.

Activity

Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

Finally

Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. If the sutures are not the dissolvable type, they will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So its really nothing to worry about.

Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Bergen or your family dentist.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office. Please try to call during office hours, however a 24-hour answering service is available for after hours contact with a doctor. The afterhours telephone number is Greenwich Office Phone Number 203-661-4231.